MEDICARE: ERICH ANTHONY REUHS MS-CCC/SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	146009653	IL

General Provider Information

NPI Number	:	1194332601
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERICH ANTHONY REUHS MS-CCC/SLP

Provider Business Mailing Address
First Line	:	2418 W EASTWOOD AVE # 2
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60625-2908
Country	:	US
Telephone Number	:	847-624-0720
Fax Number	:

Provider Business Practice Location Address
First Line	:	1415 W FOSTER AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60640-2288
Country	:	US
Telephone Number	:	847-624-0720
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/29/2020
Last Update Date	:	09/29/2020

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